Tenosynovitis of the hand and wrist
- Overview
- Theory
- Diagnosis
- Management
- Follow up
- Resources
Epidemiology
Tendinopathy is one of the most common reasons for a visit to a hand clinic. It is more common in women, with a peak incidence at about the sixth decade of life.[2]Lipscomb PR. Tenosynovitis of the hand and the wrist: carpal tunnel syndrome, de Quervain's disease, trigger digit. Clin Orthop. 1959;13:164-180.[3]Patel MR, Bassini L. Trigger fingers and thumb: when to splint, inject, or operate. J Hand Surg Am. 1992 Jan;17(1):110-3. http://www.ncbi.nlm.nih.gov/pubmed/1538090?tool=bestpractice.com [5]Harvey FJ, Harvey PM, Horsley MW. De Quervain's disease: surgical or nonsurgical treatment. J Hand Surg Am. 1990 Jan;15(1):83-7. http://www.ncbi.nlm.nih.gov/pubmed/2299173?tool=bestpractice.com [6]Murphy D, Failla JM, Koniuch MP. Steroid versus placebo injection for trigger finger. J Hand Surg Am. 1995;20:628-631. http://www.ncbi.nlm.nih.gov/pubmed/7594291?tool=bestpractice.com [7]Newport ML, Lane LB, Stuchin SA. Treatment of trigger finger by steroid injection. J Hand Surg Am. 1990;15:748-750. http://www.ncbi.nlm.nih.gov/pubmed/2229972?tool=bestpractice.com [8]Rhoades CE, Gelberman RH, Manjarris JF. Stenosing tenosynovitis of the fingers and thumb: results of a prospective trial of steroid injection and splinting. Clin Orthop Relat Res. 1984;190:236-238. http://www.ncbi.nlm.nih.gov/pubmed/6488636?tool=bestpractice.com [9]Stein AH Jr, Ramsey RH, Key JA. Stenosing tendovaginitis at the radial styloid process (de Quervain's disease). AMA Arch Surg. 1951;63:216-228. http://www.ncbi.nlm.nih.gov/pubmed/14846481?tool=bestpractice.com [10]Fahey JJ, Bollinger JA. Trigger-finger in adults and children. J Bone Joint Surg Am. 1954;36-A:1200-1218. http://www.ncbi.nlm.nih.gov/pubmed/13211713?tool=bestpractice.com [11]Kamhin M, Engel J, Heim M. The fate of injected trigger fingers. Hand. 1983;15:218-220. http://www.ncbi.nlm.nih.gov/pubmed/6884855?tool=bestpractice.com [12]Weilby A. Trigger finger: incidence in children and adults and the possibility of a predisposition in certain age groups. Acta Orthop Scand. 1970;41:419-427. http://www.ncbi.nlm.nih.gov/pubmed/5502406?tool=bestpractice.com [13]Trezies AJ, Lyons AR, Fielding K, et al. Is occupation an aetiological factor in the development of trigger finger? J Hand Surg Br. 1998;23:539-540. http://www.ncbi.nlm.nih.gov/pubmed/9726564?tool=bestpractice.com Incidence is probably not related to repetitive tasks such as keyboard use.[3]Patel MR, Bassini L. Trigger fingers and thumb: when to splint, inject, or operate. J Hand Surg Am. 1992 Jan;17(1):110-3. http://www.ncbi.nlm.nih.gov/pubmed/1538090?tool=bestpractice.com [6]Murphy D, Failla JM, Koniuch MP. Steroid versus placebo injection for trigger finger. J Hand Surg Am. 1995;20:628-631. http://www.ncbi.nlm.nih.gov/pubmed/7594291?tool=bestpractice.com [7]Newport ML, Lane LB, Stuchin SA. Treatment of trigger finger by steroid injection. J Hand Surg Am. 1990;15:748-750. http://www.ncbi.nlm.nih.gov/pubmed/2229972?tool=bestpractice.com [8]Rhoades CE, Gelberman RH, Manjarris JF. Stenosing tenosynovitis of the fingers and thumb: results of a prospective trial of steroid injection and splinting. Clin Orthop Relat Res. 1984;190:236-238. http://www.ncbi.nlm.nih.gov/pubmed/6488636?tool=bestpractice.com
The most common presentation is trigger finger, followed by de Quervain's disease (thumb extensor tendonitis in the first dorsal compartment). Pregnant and postnatal women have increased incidence of de Quervain's disease at a younger age.[14]Avci S, Yilmaz C, Sayli U. Comparison of nonsurgical treatment measures for de Quervain's disease of pregnancy and lactation. J Hand Surg Am. 2002;27:322-324. http://www.ncbi.nlm.nih.gov/pubmed/11901392?tool=bestpractice.com [15]Wolf JM, Sturdivant RX, Owens BD. Incidence of de Quervain's tenosynovitis in a young, active population. J Hand Surg Am. 2009;34:112-115. http://www.ncbi.nlm.nih.gov/pubmed/19081683?tool=bestpractice.com
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